Adherence to a "Western-type" dietary pattern is positively associated with the Apnea-Hypopnea Index in adults with obstructive sleep apnea

Ioanna Kechribari; Meropi D Kontogianni; Elizabeth Fragopoulou; Roxane Tenta; Michael Georgoulis; Kallirroi Lamprou; Emmanouil Vagiakis; Nikos Yiannakouris

doi:10.1016/j.nutres.2023.06.006

Adherence to a "Western-type" dietary pattern is positively associated with the Apnea-Hypopnea Index in adults with obstructive sleep apnea

Nutr Res. 2023 Sep:117:56-65. doi: 10.1016/j.nutres.2023.06.006. Epub 2023 Jun 28.

Authors

Ioanna Kechribari¹, Meropi D Kontogianni², Elizabeth Fragopoulou², Roxane Tenta², Michael Georgoulis², Kallirroi Lamprou³, Emmanouil Vagiakis³, Nikos Yiannakouris²

Affiliations

¹ Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece. Electronic address: ikexrimparh@yahoo.gr.
² Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece.
³ Center of Sleep Disorders, 1st Department of Critical Care, "Evangelismos" General Hospital, Athens, Greece.

PMID: 37480783
DOI: 10.1016/j.nutres.2023.06.006

Abstract

Dietary habits have been associated with obstructive sleep apnea (OSA); however, the underlying mechanisms remain unclear. We hypothesized that adherence to dietary patterns may be associated with Apnea-Hypopnea Index (AHI) and OSA severity and that insulin resistance, oxidative stress, and inflammation may act as potential mediators of these associations. This was a cross-sectional study among 269 adult participants with polysomnography-diagnosed moderate-to-severe OSA. Dietary and physical activity habits were assessed through validated questionnaires, and biochemical, inflammatory, and oxidative stress markers were measured for all volunteers. Dietary patterns were identified using principal component analysis, and mediation analyses was also performed. A "Western-type" dietary pattern (characterized by high intakes of full-fat dairy, refined grains, potatoes, red meat, sweets, salty snacks, and soft drinks and low intakes of low-fat dairy and whole grains) was positively associated with AHI. Mediation analyses also revealed that insulin resistance partially explained this association. In multivariable models controlling for age, sex, smoking, socioeconomic status, obesity presence, energy intake, and physical activity level, participants in the highest quartile of adherence to the Western-type dietary pattern had ∼3.5 times higher likelihood of suffering from severe OSA, compared with participants in the lowest quartile of adherence (odds ratio [95% confidence interval]: 3.45 [1.21-9.94], P trend across quartiles: 0.024). After further adjustment for Homeostasis Model of Assessment-Insulin Resistance and high-sensitivity C-reactive protein, this association lost significance. Higher adherence to a less healthy, Western-type dietary pattern is positively associated with AHI and OSA severity, which may partially be mediated through insulin resistance.

Keywords: Apnea-hypopnea index; Diet; Dietary patterns; Inflammation; Insulin resistance; Obstructive sleep apnea.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Anxiety
Apnea*
Cross-Sectional Studies
Diet, Western
Humans
Insulin Resistance*